Neonatal Mortality Risk Assessment in a Neonatal Intensive Care Unit (NICU)

Objective: This study aims to assess the utility of a scoring system as predictor of neonatal mortalityrate among the neonates admitted within one year to the neonatal intensive care unit (NICU) of theChildren’s Medical Center in Tehran, Iran.Material Methods: Data were gathered from 213 newborns admitted to the NICU from September2003 to August 2004. In addition to demographic data, Apgar scores at 1 minute and 5 minutes,history and duration of previous hospitalization, initial diagnosis and final diagnosis, and scoringsystem by using the score for the neonatal acute physiology-perinatal extension II (SNAP-PE II) werecarried out within 12 hours after admission to the NICU. All of the parameters were prospectivelyapplied to the admitted newborns. The exclusion criteria were discharge or death in less than 24 hoursafter NICU admission.Findings: 198 newborn infants met the inclusion criteria. The mean and standard deviation (SD) ofthe variables including postnatal age, birth weight, SNAP, and finally Apgar scores at 1 minute and 5minutes of neonates under this study were 7.6 (0.5) days, 2479.8 (29.4) grams, 21.6 (1.1), 7.47( 0.08),and 7.71 (0.06), respectively. Twenty five of the 198 patients died (12.6%). Gestational age(P=0.03), birth weight (P=0.02), Apgar score at 5 minutes (0.001), and SNAP-PE II (P=0.04) weresignificantly related to the mortality rate. By Analyzing through logistic regression to evaluate thepredictive value of these variables in relation to the risk of mortality, it was shown that only SNAPPEII and Apgar score at 5 minutes could significantly predict the neonatal mortality.Conclusion: According to this study SNAP-PE II and Apgar score at 5 minutes can be used to predictmortality among the NICU patients. SNAP-PE II score had the best performance in predictingmortality in this study. More studies with larger samples are suggested to evaluate all of the abovementioned parameters among neonates who are admitted to NICUs countrywide.